National Survey on the Mistreatment of Older Adults in Canada National Initiative for the Care of the Elderly Annual NICE Knowledge Exchange 2013

Why a Prevalence Study Matters A national prevalence study of Canada and each province provides estimates as to who is at risk for maltreatment and the size of the problem in Canada. Accurate data about abuse and neglect ensures accuracy in screening, classification, and appropriate treatment, and prevention (McDonald, Dergal & Collins 2012).

What Prevalence Data Tells Us Prevalence studies tell us: The magnitude of abuse & neglect in Canada; The distribution of the issue in Canada; Trends over time of abuse and neglect; The factors correlated with abuse and neglect; The factors that predict abuse and neglect Targets for intervention

With Numbers in Hand: The data will help federal and provincial policy makers: Develop evidence-based policies, Provide baseline data for future policy and program evaluations to assess if things improve, Will make possible international comparisons, Provide data that will accurately estimate how many human and financial resources are required to prevent and solve the problem. All Canadians benefit directly and indirectly from the protection of older adults through awareness and the savings of human and economic costs as reflected in taxes.

Existing Prevalence Data (Canada) Podnieks et al (1990); 1989 data 2,008 randomly selected older adults in Canada 4% reported some form of abuse 2.5% financial; 1.4% verbal aggression; 0.5% physical abuse Pottie Bungie (2000), criminal victimization questions in GSS 4,324 older adults in Canada, 65+ 7% psychological; 1% financial 9% of older men, 6% of older women reported being victims of emotional or financial abuse Podnieks, E.; Pillemer, K.; Nicholson, J. P.; Shillington, T. & Frizzel, A. F. (1989): A National Survey on Abuse of the Elderly: Preliminary Findings, Toronto, Ryerson Polytechnical Institute; Pottie Bunge, V. (2000). Abuse of older adults by family members. In V. Pottie Bunge & D. Locke (Eds.), Family violence in Canada: A statistical profile (pp. 27-30). Ottawa, ON: Statistics Canada.

Defining & Measuring Elder Abuse Study (2009 – 2011) Choosing Conceptual Definitions Systematic review of prevalence studies (14 community; 9 institutions) Three focus groups were held (two in English, one in French) Three dyad interviews (two in English, one in French) Consensus meeting (2 days) with major Canadian stakeholders across Canada representing researchers, practitioners and policy makers to develop conceptual definitions. Validation of Surveys Cognitive Testing of Instruments (40 in-person interviews in the community in French and English) Completed Telephone Survey of those abused and not abused (267 telephone interviews), Institutional Survey (32 face-to-face interviews)

Defining & Measuring Elder Abuse Study (2009 – 2011) Data Analyses ‘known groups’ validation method used Ethical Considerations Interviewer Training & Resource Manual Resources & Support for Participants

Defining & Measuring Elder Abuse Study (2009 – 2011) 267 respondents (community-dwelling) 122 (46%) experienced abuse or neglect in past 12 months 85 (69%) had experienced only one type of abuse “Known groups” analysis “Known abuse” group more likely to respond positively to 20/25 specific types of abuse mentioned most frequently “Known abuse” group responded positively to 3.5x more items that those in known “non-abuse” group

Defining & Measuring Elder Abuse Study (2009 – 2011) Experiencing abuse and feeling abused 122 (46%) responded “Yes” to one/several abuse items 78 (64%) felt abused 44 (36%) did not feel abused Evaluative coding of open-ended questions Why did they not feel abused? Not a vulnerable adult Non-trusted person was the perpetrator Only one incident Worked out issues Abuser was mentally incapacitated

National Survey on the Mistreatment of Older Adults in Canada Funded by New Horizons for Seniors Program, Human Resources and Skills Development Canada 2012 – 2015 Study objectives Provide national estimates of who is at risk for abuse Provide national estimates of the size of the problem Provide data for decision-making on service provision and policy development

National Survey on the Mistreatment of Older Adults in Canada Representative sample 5,000 (+) adults, aged 55+ Living in private dwellings in Canada Random-digit dialing Abuse and neglect Physical Psychological Financial Sexual

National Survey on the Mistreatment of Older Adults in Canada Provincial Oversampling British Columbia (n=500) Ontario (n=550) Quebec (n=750) Alberta (in progress) Data analysis Basic descriptives Evaluative coding

Knowledge Translation “Pocket” tool summary of key study results Paper and digital versions Disseminated to… NICE members & partners General public Academic conferences and publications

Research Team Lynn McDonald, PhD, NICE/University of Toronto Marie Beaulieu, PhD, University of Sherbrooke Simon Biggs, PhD, University of Melbourne Gloria Gutman, PhD, Simon Fraser University Sandra Hirst, PhD, University of Calgary Ariela Lowenstein, PhD, Haifa University Cynthia Thomas, PhD, Westat

Questions? Contact Anthony Lombardo, PhD Project Manager alombardo@nicenet.ca